Introduction

An Ankle X-ray is a brief, non-invasive scan that uses low-dose ionizing radiation to capture images of the bony structures around the ankle. Because the ankle is commonly injured, X-rays are often the initial investigation to confirm or rule out fractures, dislocations, and some degenerative changes. For soft-tissue injuries (ligaments, tendons, cartilage), more advanced imaging such as MRI may be required.

When is an Ankle X-ray recommended?

Your clinician may order an ankle X-ray if you have:

• A recent injury with pain, swelling or inability to bear weight

• Obvious deformity after trauma (possible dislocation)

• Persistent or unexplained ankle pain or swelling

• Suspected arthritis or long-standing joint problems

• Signs that suggest bone infection or a mass

• Follow-up after ankle surgery to check healing or hardware placement

What parts of the ankle are seen on the X-ray?

An ankle X-ray typically shows:
– The lower ends of the tibia and fibula (shin bones)
– The talus (the primary ankle bone) and nearby tarsal bones (including parts of the calcaneus)
– Joint spaces and bone surfaces where wear or narrowing may indicate arthritis

Note: muscles, ligaments and nerves are not well visualized on plain X-rays.

How should I prepare?

No special prep is usually necessary. Typical instructions:
– Remove shoes, socks and any jewellery or metal around the ankle.
– Wear loose clothing that’s easy to roll up.
– Tell staff if you are pregnant or think you might be.

Pregnancy and children — is it safe?

– Pregnancy: Because the ankle is remote from the abdomen, fetal exposure is minimal. Still, X-rays are avoided in pregnancy when possible; if essential, protective abdominal shielding is used and the physician will weigh risks versus benefits.
– Children: Ankle X-rays are commonly and safely used in children; technicians take care to keep dose as low as possible.

Typical views taken

To evaluate the ankle fully, radiographers commonly take multiple views, for example:
– AP (anteroposterior) — front to back
– Lateral — side view for alignment and displacement
– Mortise — an angled view that opens the joint space and shows the ankle mortise clearly
– Special/weight-bearing views may be requested to assess joint space under load

What happens during the test?

You’ll be seated or standing and asked to place your foot on the X-ray plate in specific positions. The technician will position the machine and take the exposures; you must remain still for a few seconds for each view. The exam is quick and does not require needles or injections.

Is the procedure painful or invasive?

No. The X-ray itself is painless and non-invasive. Any minor discomfort usually comes from holding a position or weight-bearing after injury.

How long does it take and when are results ready?

The scan itself usually takes 5–10 minutes, depending on the number of views. Results are often available within hours to a day after a radiologist reviews the images and issues a report.

Can I have an Ankle X-ray after surgery?

Yes — post-operative X-rays are routinely used to:
– Confirm correct placement of screws, plates or other hardware
– Monitor bone healing and alignment
– Detect complications such as delayed union or infection
Surgeons often order multiple follow-up X-rays to track recovery.

What can an Ankle X-ray detect?

It can show:
– Fractures or cracks in the bones
– Dislocations or subluxations
– Arthritis-related joint narrowing or bone spurs
– Bone infections or suspicious lesions
– Hardware placement and healing progress after surgery

What are the limits of an Ankle X-ray?

Ankle X-rays do not reliably demonstrate ligament tears, tendon injuries, cartilage defects, or subtle bone bruises. If these are suspected despite normal X-rays, your clinician may recommend MRI, CT or ultrasound.

How often can I have ankle X-rays?

There’s no fixed maximum, but X-rays are performed only when medically justified. Although the radiation dose per exam is low, clinicians still try to avoid unnecessary repeat imaging.

When should I seek urgent care?

Seek immediate medical attention if you experience:
– Severe deformity of the ankle
– Inability to move or bear weight on the foot after trauma
– Numbness, severe pain, or loss of circulation (cold, pale toes)
– High fever with localized ankle pain (possible infection)

Final note

An Ankle X-ray is a fast, effective first step to identify many bone and alignment problems. If your symptoms suggest soft-tissue injury or a more complex issue, your doctor will arrange the appropriate advanced imaging.